On 2017 Dec 26, Kevin Kavanagh commented:

We have expressed concerns in a previous letter and PubMed Common’s posting regarding the article by Kelly, et al,(1) where the efficacy of the evaluated product may have been overstated.(2, 3) In the authors reply, data was presented which presents less than a 30% reduction(4) as opposed to a 42% which is stated in the article and advertised by the company.(1,5) To our knowledge the peer-review record has not been corrected. In addition, we have concerns regarding at least the appearance of an undeclared conflict-of-interest between one of the article’s authors, Connie Steed, and the company in question, DebMed.(6)

It has come to the authors’ attention that the editor in charge of adjudicating the above concerns may also have a conflict-of-interest with DebMed and with one of the authors of the manuscript in question. Significant concerns regarding the conflicts of interest of the Editor Elaine Larson have arisen because of the following associations:

• Co-Author with Connie Steed (one of the authors in the manuscript in question) and Paul Alpert (Vice President of Patient Safety Strategy for DebMed) in an article published in Feb 2011.(7). Conflicts-of-Interest stated the following “Elaine Larson has received research funding from Deb Worldwide Healthcare, Inc.”

• Co-Author with Paul Alpert (Vice-President of Patient Safety Strategy for DebMed) in an article published in Jan 2013.(8)

• Co-Author with Paul Alpert (Vice-President of Patient Safety Strategy for DebMed) in an article published in Feb 2014.(9)

• Connie Steed, RN is listed as the 2016 Secretary for the Association for Professionals in Infection Control and Epidemiology, Inc., which has as its official publication the American Journal of Infection Control(10) and provides this Journal as a benefit of their membership.(11)

We feel that because of the above, the appearance of a conflict of interest exists which may have clouded the decision making and inhibited the correction of the potential research integrity problems in the article in question.

References

(1) Kelly, J.W., Blackhurst, D., McAtee, W., and Steed, C. Electronic hand hygiene monitoring as a tool for reducing health care-associated methicillin-resistant Staphylococcus aureus infection. Am J Infect Control. 2016; 44: 956–95 Kelly JW, 2016

(2) Kavanagh KT, Saman DM. Comment Regarding: Electronic hand hygiene monitoring as a tool for reducing health care–associated methicillin-resistant Staphylococcus aureus infection. American Journal of infection Control. December 01 2016 http://www.ajicjournal.org/article/S0196-6553(16)30904-X/fulltext

(3) Kavanagh KT, Saman DM. Comment on PMID: 27908437: Response to Letter Regarding Manuscript “Electronic Hand Hygiene Monitoring as a Tool for Reducing Nosocomial Methicillin-resistant Staphylococcus aureus Infection” In: PubMed Commons [Internet]. Bethesda (MD): National Library of Medicine; 2016 Dec. 16. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27908437#cm27908437_34333

(4) Kelly JW, Blackhurst D, McAtee W, Steed C. Response to Letter Regarding Manuscript "Electronic Hand Hygiene Monitoring as a Tool for Reducing Nosocomial Methicillin-resistant Staphylococcus aureus Infection". Am J Infect Control. 2016 Dec 1;44(12):1763. doi>: 10.1016/j.ajic.2016.08.009. http://www.ajicjournal.org/article/S0196-6553(16)30812-4/fulltext Kelly JW, 2016

(5) DebMed: Discover how one facility was able to reduce MRSA HAIs by up to 42%. Last accessed on Dec. 21, 2017 from http://info.debmed.com/mrsa-study-flyer

(6) Hospital Reduces MRSA Rates by 42% with electronic hand hygiene measurement. Infection Control Today. July 8, 2016. http://www.infectioncontroltoday.com/news/2016/07/hospital-reduces-mrsa-rates-by-42-with-electronic-hand-hygiene-measurement.aspx

(7) Connie Steed, MSN, RN, CIC J. William Kelly, MD Dawn Blackhurst, DrPH Sue Boeker, BSN, RN, CIC Thomas Diller, MD, MMM Paul Alper, BA Elaine Larson, RN, PhD, FAAN, CIC Hospital hand hygiene opportunities: Where and when (HOW2)? The HOW2 Benchmark Study. American Journal of Infection Control. Feb 2011 39(1):19-26. Steed C, 2011

(8) Buet A, Cohen B, Marine M, Scully F, Alper P, Simpser E, Saiman L, Larson E. Hand hygiene opportunities in pediatric extended care facilities. J Pediatr Nurs. 2013 Jan;28(1):72-6. doi: 10.1016/j.pedn.2012.04.010. Epub 2012 Jun 1. Buet A, 2013

(9) Conway LJ, Riley L, Saiman L, Cohen B, Alper P, Larson EL. Implementation and impact of an automated group monitoring and feedback system to promote hand hygiene among health care personnel. Jt Comm J Qual Patient Saf. 2014 Sep;40(9):408-17. Conway LJ, 2014

(10) American Journal of Infection Control Home Page. Accessed on Dec. 26, 2017 from https://www.journals.elsevier.com/ajic-american-journal-of-infection-control

(11) Association for Professionals in Infection Control and Epidemiology, Inc. Web Posting. Accessed on Dec. 26, 2017 from http://www.ajicjournal.org/article/S0196-6553(15)01270-5/pdf

Comment also posted on PubPeer

On 2017 Dec 26, Kevin Kavanagh commented:

We have expressed concerns in a previous letter and PubMed Common’s posting regarding the article by Kelly, et al,(1) where the efficacy of the evaluated product may have been overstated.(2, 3) In the authors reply, data was presented which presents less than a 30% reduction(4) as opposed to a 42% which is stated in the article and advertised by the company.(1,5) To our knowledge the peer-review record has not been corrected. In addition, we have concerns regarding at least the appearance of an undeclared conflict-of-interest between one of the article’s authors, Connie Steed, and the company in question, DebMed.(6)

It has come to the authors’ attention that the editor in charge of adjudicating the above concerns may also have a conflict-of-interest with DebMed and with one of the authors of the manuscript in question. Significant concerns regarding the conflicts of interest of the Editor Elaine Larson have arisen because of the following associations:

• Co-Author with Connie Steed (one of the authors in the manuscript in question) and Paul Alpert (Vice President of Patient Safety Strategy for DebMed) in an article published in Feb 2011.(7). Conflicts-of-Interest stated the following “Elaine Larson has received research funding from Deb Worldwide Healthcare, Inc.”

• Co-Author with Paul Alpert (Vice-President of Patient Safety Strategy for DebMed) in an article published in Jan 2013.(8)

• Co-Author with Paul Alpert (Vice-President of Patient Safety Strategy for DebMed) in an article published in Feb 2014.(9)

• Connie Steed, RN is listed as the 2016 Secretary for the Association for Professionals in Infection Control and Epidemiology, Inc., which has as its official publication the American Journal of Infection Control(10) and provides this Journal as a benefit of their membership.(11)

We feel that because of the above, the appearance of a conflict of interest exists which may have clouded the decision making and inhibited the correction of the potential research integrity problems in the article in question.

References

(1) Kelly, J.W., Blackhurst, D., McAtee, W., and Steed, C. Electronic hand hygiene monitoring as a tool for reducing health care-associated methicillin-resistant Staphylococcus aureus infection. Am J Infect Control. 2016; 44: 956–95 Kelly JW, 2016

(2) Kavanagh KT, Saman DM. Comment Regarding: Electronic hand hygiene monitoring as a tool for reducing health care–associated methicillin-resistant Staphylococcus aureus infection. American Journal of infection Control. December 01 2016 http://www.ajicjournal.org/article/S0196-6553(16)30904-X/fulltext

(3) Kavanagh KT, Saman DM. Comment on PMID: 27908437: Response to Letter Regarding Manuscript “Electronic Hand Hygiene Monitoring as a Tool for Reducing Nosocomial Methicillin-resistant Staphylococcus aureus Infection” In: PubMed Commons [Internet]. Bethesda (MD): National Library of Medicine; 2016 Dec. 16. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27908437#cm27908437_34333

(4) Kelly JW, Blackhurst D, McAtee W, Steed C. Response to Letter Regarding Manuscript "Electronic Hand Hygiene Monitoring as a Tool for Reducing Nosocomial Methicillin-resistant Staphylococcus aureus Infection". Am J Infect Control. 2016 Dec 1;44(12):1763. doi>: 10.1016/j.ajic.2016.08.009. http://www.ajicjournal.org/article/S0196-6553(16)30812-4/fulltext Kelly JW, 2016

(5) DebMed: Discover how one facility was able to reduce MRSA HAIs by up to 42%. Last accessed on Dec. 21, 2017 from http://info.debmed.com/mrsa-study-flyer

(6) Hospital Reduces MRSA Rates by 42% with electronic hand hygiene measurement. Infection Control Today. July 8, 2016. http://www.infectioncontroltoday.com/news/2016/07/hospital-reduces-mrsa-rates-by-42-with-electronic-hand-hygiene-measurement.aspx

(7) Connie Steed, MSN, RN, CIC J. William Kelly, MD Dawn Blackhurst, DrPH Sue Boeker, BSN, RN, CIC Thomas Diller, MD, MMM Paul Alper, BA Elaine Larson, RN, PhD, FAAN, CIC Hospital hand hygiene opportunities: Where and when (HOW2)? The HOW2 Benchmark Study. American Journal of Infection Control. Feb 2011 39(1):19-26. Steed C, 2011

(8) Buet A, Cohen B, Marine M, Scully F, Alper P, Simpser E, Saiman L, Larson E. Hand hygiene opportunities in pediatric extended care facilities. J Pediatr Nurs. 2013 Jan;28(1):72-6. doi: 10.1016/j.pedn.2012.04.010. Epub 2012 Jun 1. Buet A, 2013

(9) Conway LJ, Riley L, Saiman L, Cohen B, Alper P, Larson EL. Implementation and impact of an automated group monitoring and feedback system to promote hand hygiene among health care personnel. Jt Comm J Qual Patient Saf. 2014 Sep;40(9):408-17. Conway LJ, 2014

(10) American Journal of Infection Control Home Page. Accessed on Dec. 26, 2017 from https://www.journals.elsevier.com/ajic-american-journal-of-infection-control

(11) Association for Professionals in Infection Control and Epidemiology, Inc. Web Posting. Accessed on Dec. 26, 2017 from http://www.ajicjournal.org/article/S0196-6553(15)01270-5/pdf

Comment also posted on PubPeer